Notebook > Lifestyle

Under the weather

"Under the weather" Continued...

Issue: "Tick, tick, tick ...," May 7, 2011

Despite the satisfaction inherent in the work, the Ecks find it hard to recruit physicians to volunteer at the clinic. They speculate that the stress and time demands of running a private practice keep many from volunteering.

That's why they are proposing an alternative: What if New Jersey did away with Medicaid altogether? What if the state encouraged more doctors to voluntarily care for the poor at free clinics like Zarephath? And what if, in exchange, the state would provide doctors with malpractice coverage in their private practices, relieving them of that financial burden and discouraging frivolous lawsuits, since the state, like the federal government, is less likely to settle nuisance suits than private insurers are.

They believe the result would be better care for the poor and financial savings overall: "If the state were to say we will protect doctors, the doctors would order fewer tests. A good doctor who is a good clinician will give better care."

Verghese, from his different vantage point, similarly concludes that today's system is bad for budgets, doctors, and patients. Tending to the iPatient, he writes, "can't begin to compare with the joy, excitement, intellectual pleasure, pride, disappointment, and lessons in humility that trainees might experience by learning from the real patient's body examined at the bedside." Verghese describes the careful physical exam as ritual, which "strengthens the patient--physician relationship and enhances the Samaritan role of doctors-all rarely discussed reasons why we should maintain our physical-diagnosis skills."

Verghese concludes with a cry for better medical training to produce better clinicians, those who understand "the bedside is hallowed ground, the place where fellow human beings allow us the privilege of looking at, touching, and listening to their bodies. Our skills and discernment must be worthy of such trust." But that's unlikely to happen unless we make our medical system hospitable once again to doctors like the Ecks and the elder Dewars.

Susan Olasky
Susan Olasky

Susan pens book reviews and other articles for WORLD as a senior writer and has authored eight historical novels for children. Susan and her husband Marvin live in Asheville, N.C. Follow Susan on Twitter @susanolasky.

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